National Journal of Health Sciences
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Adjunct Use of Low Dose Risperidone Verses Adjunct Use of Clonazepam with an SSRI in Treatment of Moderate to Severe Anxiety States; A Comparative Study
No full textAbstract: Background: The unprecedented and unaccounted use of benzodiazepines is running havoc in many countries in terms of substance abuse problems and is exponentially increasing. The prescription of benzodiazepines should be minimized and the search for and use of better alternatives be incorporated into clinical practice of Psychiatry. Aim: The aim of this study is to compare the efficacy of low dose risperidone and relatively higher dosage of clonazepam in moderate to severe anxiety states when used in combination with an SSRI. Method: A group of 60 patients having moderate to severe anxiety level, as measured by Hamilton Anxiety Rating Scale (HARS) were randomly divided into two groups. First group was given 1 mg risperidone with 50 mg Sertraline and the second group was given 3 mg of clonazepam with 50 mg Sertraline. The anxiety levels of patients in both groups were again calculated on the 10th post treatment day and compared to each other. Moreover, the Side Effect profiling of Risperidone was also done in all the Patients by using the Glasgow Anti-psychotic Side-effect Scale (GASS)’. Result: The first group had a decrease in the HARS scores having a value of 19.56 between day 0 and day 10. The second group also showed a decrease in the anxiety levels with a mean HARS score of 31.12 on day 0 to 12.36 on day 10. The mean value of decrease in HARS score was comparable. Conclusion: The efficacy of low dose risperidone is comparable to that of relatively high dose of clonazepam in treating moderate to severe anxiety states. Use of risperidone for symptomatic relief from anxiety is a viable alternative to benzodiazepines
Are Home Based Pelvic Floor Muscle Exercises (PFMES) Effective in Prevention of Stress Urinary Incontinence During Pregnancy? A Randomized Controlled Trial
No full textABSTRACT: Objectives: To determine effectiveness of 8 weeks home based PFMEs in the prevention of stress urinary incontinence (SUI) during pregnancy and to see how many women were consistent with them. Materials And Methods: This randomized controlled trial was conducted in the outpatient department (OPD) of Obstetrics/Gynaecology, Kahuta Research Laboratories (KRL) hospital, Islamabad during Nov, 2017 to Jan,2018. After fulfilling the inclusion/exclusion criteria, women were randomly divided into two groups. One group learned to perform PFMEs. A telephonic survey was conducted after 8 weeks andall the women in the study were asked about presence/absence of perceived urinary incontinence. Data were analysed using descriptive statistics. Results: A total of 120 women were randomized into the study. Amongst those who were followed, 63.4% from intervention group didn’t adhere to PFMEs and dropped out from study. A total of 42 women were analysed from both groups. Mean age was 25+-3 years and mean gestational age was 23+-4 weeks. Thirty nine percent were nullipara. Amongst women in the intervention group, majority were still continent after 8 weeks of PFMEs (86.6%) and only few experienced SUI (13.4%). However, when these women were matched with controls, fewer women as compared to intervention group were continent after 8 weeks (55.6%). Conclusion: Home based pelvic floor muscle exercises are very effective in prevention of stress urinary incontinence in only highly motivated patients
Observational Study on Standard Practices of Nurses in Birth Asphaxia Management at a Tertiary Care Hospital, Lahore, Pakistan
No full textAbstract: Background: Neonatal mortality is the death of newborn baby in first 28 days of life. Approximately 1 million newborn die in early 24 hours and 2 million more will be die in next 7 days of birth. Birth asphyxia is a medical condition which results due to lack of oxygen to newborn and last for long time, causing different morbidities and physical harm. It is the third major cause of newborn death, according to world health organization.Aim: Aim of the study was to observe the practices of nurses for adherence on standard protocols towards birth asphyxia management.Methods: A descriptive cross-sectional study was conducted at a tertiary care hospital. The population was n=153 nurses, working in labour room and nursery. Study duration was 4months. Data was collected by observational checklist consisted of 19 items to observe the practices of nurses. Data was analyzed by the categories of the < 60 show poor practices, 61-74 gives average while > 75 show good practices. Ethical approval was taken from participants as in written consent.Results: Majority of Nurses 83% Nurses having experience above 10 years and show good practices towards management of birth asphyxia and 38% have good practices having age 25 years to 34 years. While the nurses having experience of less than five years 44% and age under 24 years (11%) show poor practices.Conclusion: Early detection of Birth asphyxia and management is critical to reduce neonatal mortality. Experienced nurses show good practices but there was some problems due to which standard protocols could not followed, as lack of staff nurses, bad attitude, lack of equipments and overburdened
Nipah Virus- A Rapidly Emerging Zoonoses: A Mini Review
No full textAbstract: Nipah virus is one of the deadliest viruses of Paramyxoviridae family, of the order Mononegavirales. The virus is harbored by Pteropus fruit bats and transmitted to pigs via partially eaten fruits or direct exposure to infectious bat secretions. Viral determinants that contribute to Nipah virus infection include V and W proteins where W protein plays a more prominent role. It is Known for causing severe and rapidly progressive encephalitis and thus classified among BSL-4 organisms due to its high mortality rate and lack of vaccines and drugs. Due to wide spread primary host the potential for outbreaks to occur in new regions remains significant and suggests a serious potential for larger epidemics in the future. Therefore proper management and preventive measures are needed to be implemented by health care workers, as well as at the government level
HB Q India in Two Sindhi Hindu Families of Sindh
No full textAbstract: Hemoglobin Q is one of the alpha chain variants resulting from structural changes in alpha 1 globin gene. It is often heterozygous in form and clinically silent even in the presence of beta thalassemia trait in compound heterozygous form. We identified two Sindhi Hindu families with hemoglobin Q India, one is compound heterozygous for Hb Q India and thalassemia trait, while other has heterozygous Hb Q India variant. These samples were booked for routine hemoglobinopathy screening and the variant was suspected after finding an unknown peak at a retention time of 4.68 seconds, performed on high performance liquid chromatography(HPLC). For confirmation, these samples were sent for DNA analysis for the presence of suspected Hb Q India mutation, using amplification refractory mutation system (ARMS)
How We Managed Primary Immunodeficiency Disorders in Pakistan – A Case Based Study
No full textIntroduction: This article emphasizes on the importance of time frame for diagnosis and management of immunodeficiency syndromes and also highlights the diagnostic dilemma that most often such cases are misdiagnosed or undiagnosed which contributes to significant morbidity and mortality. Case Presentation: This article with the help of five exemplary cases illustrates the different types of primary immunodeficiencies including severe combined immunodeficiency (SCID), and their varied clinical presentations and management and also describes the difficulty in reaching final diagnosis and a brief review of literature on primary immunodeficiency and its therapeutic approach. Management and Outcome: All the patients described in this case based study underwent Hematopoietic stem cell transplant; the definitive therapeutic approach for all kinds of immunodeficiency syndromes. Four out of five patients were successfully treated, unfortunately one could not survive. Discussion: The purpose of this article is to raise public health awareness regarding prevalence of primary immunodeficiency disorders and their possible cure via hematopoietic stem cell transplant, if diagnosed and managed promptly
Child Abuse in Pakistan-Current Perspective
No full textIt’s not been long that the case of Baby Zainab from Qasur, a city in Punjab made the headlines in the media. Prior to this incidence cases of sexual abuse of over 200 children from the same city created an uproar in the media and in the country. In the past few years there has been an upsurge in the cases of child abuse reported in the media. The concerns over rising incidence of child abuse and neglect has received global attention. A number of national and international organization have shown serious concerns and are demanding strict measures to tackle the issues of child protection
Predicting Surgical Site Infection by ‘Suction Drain Tip’ and ‘Drain Fluid’ Cultures: Are they Helpful?
No full textAbstract: Introduction: The aim of the study was to check the predictability of ‘suction drain tip’ and ‘drain fluid’ cultures for detecting their association with possible surgical site infection. Material and Methods: This was an observational study conducted in Surgical Unit 1, Civil Hospital Karachi from February 2017 to November 2017. All post-operative patients having closed drains were included in the study excluding the patients who did not require drains in post-operative period. Cultures from drain fluid and drain tip were sent. The sensitivity, specificity, positive and negative predictive values were calculated. Result: The predictability for surgical infections in positive drain tip cultures showed Sensitivity =100% and Specificity = 61%. With Positive Predictive Value = 30.3 % and Negative Predictive Value = 100%. In drain fluid cultures the sensitivity was slightly low (85% ) with Specificity = 76.3%. Positive Predictive Value = 37.8% and Negative Predictive Value = 96.8%. Conclusion: We conclude that positive tip cultures and drain fluid can be important predictors of infection with high sensitivity but low specificity
Pinworm (Enterobius vermicularis) Infection among Primary Level Government School Children of Chhampi, Lalitpur District, Nepal
No full textAbstract: Introduction: Poor sanitation and crowding effect are easy way for transmission of enterobiasis between infected anduninfected person and it is usually common among playgroup and school kids. Subject and Methods: Among the various health problem of school children, enterobiasis is one of them still present among the school children in context of Nepal. Unawareness along with unhygienic lifestyle as well as crowdy environment may be the major reasons behind this. This study was aimed to find enterobiasis of school children in Chhampi, Lalitpur. The students were categorized on basis of age, sex, ethnic group, itching habit, nail biting habit and playing with domestic pets habit. A total of 107 cellophane samples of 2-13 years aged childrenwere included for the microscopic examination. Result: Overall 11(10.28%) enterobiasis prevalence were reported in children including 10.91% male and 9.26% female. Age group 5-7 years was found to be highly infected (4.67%). There was absence of enterobiasis among the age group 11-13 years. There was insignificant statistics association ethnically with the enterobiasis however the prevalence rate was higher in Janajati (54.54%). There were no significant association between pinworm infection with scratching habit around anus (P > 0.05) and nail biting habit (P > 0.05) of children. Conclusion: The prevalence was found to be high among primary level children and Scotch tape was a specific test for the detection of eggs of pinworm against enterobiasis
A Profound Insight of Cardiopulmonary Resuscitation (CPR) in Pakistan
No full textSudden Cardiac Arrest is considered as a major unresolved health issue and prevalence of cardiac emergencies are common in Pakistan. Many people are suffering from different cardiac diseases which include heart attack, cardiac arrest and congestive heart failure. Multiple deaths are reported especially in rural areas due to sudden cardiac events